Seung Up Kim1, Dongbeom Song2, Ji Hoe Heo2, Joonsang Yoo2, Beom Kyung Kim1, Jun Yong Park1, Do Young Kim1, Sang Hoon Ahn1, Kwang Joon Kim3, Kwang-Hyub Han1, Young Dae Kim4. 1. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea. 2. Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea. 3. Severance Executive Healthcare Clinic, Seoul, South Korea; Severance Check-up Severance Hospital, Yonsei University Health System, Seoul, South Korea. 4. Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: neuro05@yuhs.ac.
Abstract
BACKGROUND AND AIMS: The relationship between liver fibrosis and the occurrence of ischemic stroke is unknown. We investigated the correlation between liver fibrosis assessed with transient elastography (TE) and the risk of ischemic stroke. METHODS: Between April 2013 and August 2014, patients with acute ischemic stroke and subjects who underwent a health check-up were included in the study. Liver fibrotic burden was assessed with TE in all participants. The degree of liver fibrosis was compared between groups by using various multiple logistic regression models and propensity-score matched analyses. RESULTS: Two hundred ninety-five patients with ischemic stroke (stroke group) and 1942 subjects with health check-up (control group) were included. The mean liver stiffness (LS) on TE (5.6 vs. 4.1 kPa) and the proportion of significant fibrosis (>8 kPa) (9.2% vs. 1.8%) were significantly higher in the stroke than in the control group (all p<0.05). These trends were observed regardless of body mass index, the degree of hepatic steatosis, and metabolic syndrome (all p<0.05). The adjusted odds ratio (OR) for ischemic stroke was 1.268 (95% confidence intervals [CI] 1.183-1.358) per 1 kPa increase and 12.033 (95% CI 5.180-27.948) for significant fibrosis, compared with no fibrosis (all p < 0.05). Propensity-score matched analysis also confirmed that liver fibrosis was independently associated with the risk of ischemic stroke (OR 1.804 [95% CI 1.461-2.230] per 1 kPa increase, 13.184 [95% CI 3.127-55.645] for significant fibrosis, compared with no fibrosis; all p<0.001). CONCLUSIONS: The degree of liver fibrosis, assessed with TE, was significantly associated with the risk of ischemic stroke.
BACKGROUND AND AIMS: The relationship between liver fibrosis and the occurrence of ischemic stroke is unknown. We investigated the correlation between liver fibrosis assessed with transient elastography (TE) and the risk of ischemic stroke. METHODS: Between April 2013 and August 2014, patients with acute ischemic stroke and subjects who underwent a health check-up were included in the study. Liver fibrotic burden was assessed with TE in all participants. The degree of liver fibrosis was compared between groups by using various multiple logistic regression models and propensity-score matched analyses. RESULTS: Two hundred ninety-five patients with ischemic stroke (stroke group) and 1942 subjects with health check-up (control group) were included. The mean liver stiffness (LS) on TE (5.6 vs. 4.1 kPa) and the proportion of significant fibrosis (>8 kPa) (9.2% vs. 1.8%) were significantly higher in the stroke than in the control group (all p<0.05). These trends were observed regardless of body mass index, the degree of hepatic steatosis, and metabolic syndrome (all p<0.05). The adjusted odds ratio (OR) for ischemic stroke was 1.268 (95% confidence intervals [CI] 1.183-1.358) per 1 kPa increase and 12.033 (95% CI 5.180-27.948) for significant fibrosis, compared with no fibrosis (all p < 0.05). Propensity-score matched analysis also confirmed that liver fibrosis was independently associated with the risk of ischemic stroke (OR 1.804 [95% CI 1.461-2.230] per 1 kPa increase, 13.184 [95% CI 3.127-55.645] for significant fibrosis, compared with no fibrosis; all p<0.001). CONCLUSIONS: The degree of liver fibrosis, assessed with TE, was significantly associated with the risk of ischemic stroke.
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